Final form of MAID essay collection in works

Leaders ponder what’s next in church’s ‘deep, deep wrestling’ with issue as eligibility expected to widen

A collection of 25 writings by clergy, caregivers, academics and others from across Canada, an earlier version of which was made available online in fall 2023, is expected to be published in its final form both in print and digitally early this year, Anglican Church of Canada communications manager Alicia Brown says.

Submissions for the final draft of Faith Seeking Understanding: Medical Assistance in Dying closed Nov. 17 and as this issue was being prepared for publication the Rev. Eileen Scully, the national church’s director of Faith, Worship and Ministry, was preparing the final version. That version, Scully says, will include a discussion guide, meant to provide a framework for bishops, clergy and lay leaders to use in conversations on MAID in their home parishes and dioceses.

As the church grapples with questions about how it will respond to changes in Canada’s MAID legislation, Scully says she has heard from many people searching for resources to help them grasp the parameters of the discussion. They want to know what the major theological questions are and what positions members of the church are taking on them. So while the collection does not represent an official position paper of the national church on MAID, Scully says her hope is that it can communicate the breadth of the discussion to clergy and inform the conversations they have with their local colleagues.

“I think the most important conversations are those that are happening locally under the leadership of local bishops within dioceses. I think that that is the critical place for the conversation—amongst the pastors with their chief pastor,” she says.

The essays range from favourable meditations on the compassionate utility of MAID to criticisms arguing it’s incompatible with Christian teaching on the sanctity of life. Several also raise questions about the 2021 change in Canadian law to make MAID accessible to people suffering from chronic disabilities and pain but whose death is not “reasonably foreseeable” and the potential expansion of eligibility next March to those suffering only from mental illness. But the central question they expose, says Scully, is how the church and its representatives should minister to people who have opted for MAID, both in terms of what they can do to help amid the grief, fear and pain of a difficult life-and-death decision, and—in what she emphasizes is a minority of voices—whether and how clergy who disagree with the policy can ethically continue their ministry to people who have opted for it.

“It’s a deep, deep, deep wrestling and those are positions that I don’t know how they can be reconciled,” she says.

The Anglican Journal also spoke about the essay collection with some church leaders at the November meeting of the Council of General Synod (CoGS). Bishop Susan Bell, of the diocese of Niagara, says she sees parishioners and clergy in the communities she ministers to seeking resources to define their own conversations on MAID. Many are concerned about the potential change to offer the procedure to people who are suffering only from mental anguish, she says, while others have said they wanted a definitive statement from the national church on whether it supports MAID. And while such a statement does not seem likely in the short term, she says, the essay collection was a compassionate and effective way to go about starting that conversation.

As laws continue to change, it’s vital for the church to continue to keep its resources up to date, she says. The last time the Anglican Church of Canada published a resource on MAID was 2016’s In Sure and Certain Hope, which came out the same year the procedure became officially legal in Canada.

“How much has the world changed in the past three years?” asks Bell, “The clergy have been present at, have walked alongside, have prayed with, have certainly done funerals for folks who have chosen medical assistance in dying. And so that’s a different reality than at the beginning of this journey.”

In 1998 the church released Care in Dying: A Consideration of the Practices of Euthanasia and Physician Assisted Suicide, a report that opposed its legalization. In Sure and Certain Hope, however, argued neither for nor against, on the grounds that new legislation had made it a reality. In 2022, Archbishop Linda Nicholls, primate of the Anglican Church of Canada, said the church should focus its efforts on pastoral care to people considering MAID rather than opposing the law; in a 2023 opinion piece, she said she was concerned about potential extensions of MAID eligibility and people making choices out of fear or a lack of support.

The concerns of people with mental and physical disabilities, the realities of an unprecedented number of seniors entering the care system at the same time and the increasing availability of MAID will each shift the terms of the conversation—some in ways that may challenge the church to draw a limit on what forms and applications of MAID it can support and which ones it can’t, Bell says.

“If you’re working with those who are marginalized, it’s going to become more and more of an issue,” she says. “That’s where I think the church will have some decisions to make and some advocacy to engage in.”

Canon Stephen Fields, sub-dean of St. James Cathedral in Toronto, says he expects the cathedral to use it regularly to guide conversations in its pastoral care training, setting it in its broader context of how to live a sacred life and die a sacred death.

Like Bell, however, Fields says he can see a limit to what the church may be able to endorse when it comes to MAID, considering the relaxation of the requirement that a patient’s death be reasonably foreseeable and the open question about mental anguish.

“My question is, where does it end? How low does the threshold go? What’s the next change that is coming down the pipe?” he asks.